The charitable sector has come in for a bit of a beating in the press lately, much of it deserved. It does, I think, offer an opportunity to think again about the role charities play in the healthcare sector. Much of current research in health is supported by charitable donation. Also, many charities offer care services funded in varying degrees by donation.

A few years ago, on one of those TV debate programmes much targeted by the likes of Chris Morris, someone who declared himself to be a humanist announced that all charities should be made illegal.

His reasoning was that they provide services that a government should be providing through a fair, though presumably high cost, tax system. His views were ridiculed by the audience, and this seemed to be as much disgust at the audacity of somebody questioning our saintly charities than disagreement with an unsustainable tax burden.

Many charities are run like small businesses with paid employees salaried at rates that, it is argued, encourage the required talent to the roles. Many charities have investment portfolios which may increase the value of charitable assets but also leave them vulnerable to loss when there is a downturn in the economy. This was the case for one of our blind charities in the 1990s.

A hard fact to swallow is that true altruism is hard to prove. Many of us donate in order to help, but this donation is often driven by guilt or perhaps a need to satisfy ourselves that we are doing good. Donation also tends to favour certain charitable sectors leading to funding imbalances. Eye care does well here as the public love guide dogs and also sight charities have an enormous emotive appeal.

My problem is that, in an age where philanthropic millionaires are more focused on space travel, it is all too easy for a government bent on austerity to rely on charitable support which tends to extract money from the less well-off but conscientious public. Time for a rebalance.